Clinical evaluation of Al-test patch test.
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Humans↗
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Behaviour of contact allergy and new sensitivities on subsequent patch tests.
Patch tests repeated one or more times over periods of up to 3 years in 208 subjects with allergic contact dermatitis produced evidence of persistent specific sensitivities in almost 50% of cases. In about 25% the reactivity disappeared and over 25% developed new sensitivities. No new sensitivities appeared in 253 patients with non-allergic contact dermatitis or with other types of dermatitis in whom the same patch tests were carried out. The history and follow-up of patients with new sensitivities brought into focus the presumed aetiopathogenetic role of further contacts, especially occupational or after topical applications. Patch tests themselves, provided the correct technique is employed especially as regards the concentration of allergens, do not seem to be responsible for new sensitizations to any significant extent.
Adolescent↗
Lymphocyte-stimulation tests and patch tests to carbamazepine hypersensitivity.
Seven cases of severe hypersensitivity to carbamazepine (Tegretol) were described in patients with epilepsy or trigeminal neuralgia. Clinical manifestations consisted of fever, rash, facial oedema, lymphadenopathy, impaired liver function, eosinophilia and atypical lymphocytes in the peripheral blood. Lymphocyte-stimulation tests with carbamazepine in vitro showed positive results in all cases; patch tests with carbamazepine were positive in six cases. In two cases the lymphocyte-stimulation tests with carbamazepine were found to be negative during, and shortly after, the illness. However, when the tests were repeated several months later, they turned out to be positive. Lymphocyte reactivity to PPD and PHA in vitro was also impaired during the acute phase of the disease. Thus false-negative lymphocyte-stimulation tests may be found in the first months following such a hypersensitivity reaction, probably due to impaired lymphocyte reactivity. As carbamazepine is a potent drug and is often prescribed for long periods together with other anticonvulsants, it seems important to prove that the allergic reaction is caused by carbamazepine. If the lymphocyte-stimulation test in vitro or the patch test with carbamazepine is found to be negative during or shortly after the illness, they should be repeated several months later.
Carbamazepine↗
Chamber test versus patch test for epicutaneous testing.
A new modification of the chamber test for epicutaneous testing, and improved auxiliary equipment are presented. Compared with the customary patch test, the chamber test in its present form has several remarkable advantages, which are described in detail.
Dermatitis, Contact↗
Experimental investigations in guinea pigs on the recognition of the allergic eczematous reaction: A comparison of the macrophage migration inhibition test with the patch test.
1. The patch test as an in vivo test has disadvantages. It is our impression that biologically false reactions occur in approximately 5%. 2. The MIT as an in vitro test is very time consuming, but safe for the patient. It is supposed to give up to 20% false reactions. 3. In 76 and 72% of 156 guinea pigs sensitized with potassium bichromate and sulfasol respectively, both the test methods gave results in agreement. 4. Sensitization by potassium bichromate estimated by patch test only was 30%, and by MIT only also 30%, but the two test methods disagreed in 24%. 5. Sensitization by sulfasol evaluated in the patch test only was 36%, and in the MIT only 48% but the two test methods disagreed in 28%. 6. The differences between the results of the two test methods are not satistically significant and their failure rate does not provide absolutely sure results, but we believe that the patch test is preferrable in recognition of contact allergy because it is in vivo and probably has a lower failure rate in comparison with the MIT in the human.
Animals↗
Comparative study of TRUE Test and Finn Chamber patch test techniques in Singapore.
This is a report on a comparative study of the reactivity of TRUE Test and Finn Chamber patch test techniques. 413 patients attending a contact dermatitis clinic in Singapore were simultaneously patch tested with panels 1 and 2 of the TRUE Test standard series and with corresponding allergens (Hermal, Hamburg) using Finn Chambers. The left/right application of the TRUE Test and Finn Chambers was randomized. The concordance of positive patch test reactions to the 2 test techniques was studied. The number of patient with positive reactions was 38% and 42% for TRUE Test and Finn Chamber techniques, respectively (n.s.). The overall concordance of positive patch test reactions was 64% (209/328). 13% (42/328) of positive reactions appeared on TRUE Test only and 24% (77/328) on Finn Chamber only. When only relevant positive reactions were considered, the concordance rate was 67%; 11.6% of positive reactions appeared on TRUE Test only and 21% on Finn Chamber only. Positive reactions to p-phenylenediamine (PPD) and neomycin were more frequent with the Finn Chamber technique than with TRUE Test, i.e., false negative reactions to PPD and neomycin were more likely to occur with TRUE Test. It appeared that the TRUE Test and Finn Chamber techniques were comparable when used for patch testing. However false negative and false positive patch test reactions can occur when using either technique.
Adolescent↗
Patch testing in the rabbit using a modified human patch test method. Application of histological and visual assessement.
A 5 h, semi-occlusive human patch test repeated daily for 5 days, was modified for use in the rabbit Using this method, the relative irritancy of three cosmetic samples of known human irritancy was determined in the rabbit. In addition, attention was paid to assessment methods and a detailed histological scoring system is described as well as two methods of visual assessment. In order to compare the effectiveness of these methods, the reaction to a series of concentrations of sodium lauryl sulphate was examined. All three assessment methods gave similar results and the merits of combining histological and visual assessment are discussed.
Acanthosis Nigricans↗
A retrospective study of Patch test results from 163 patients with stasis dermatitis or leg ulcers. I. Discussion of the Patch test results and the sensitization indices and determination of the relevancy of positive reactions.
Patch test results from 163 patients with leg ulcers and/or chronic venous insufficiency, tested with a modified ICDRG standard test battery and a pharmaceutical test series, are analyzed and compared with the results obtained from a randomly selected control group of patients with eczematous conditions. A sensitization index for the most common contact allergens present in this test series is calculated, and the relevancy of hypersensitivity to specific topical agents is determined.
Allergens↗
[Skin and laboratory tests: comparison of the epicutaneous patch test with the TTL and LIF tests in the diagnosis of medicamentous allergic contact dermatitis].
We investigated 158 patients from 15 to 82 years of age with clinically evident contact dermatitis, diagnosed at the Department for Allergic Diseases Investigations-Clinic for Dermatovenerological Diseases, Medical Faculty in Novi Sad, during the period of 1 year. We performed patch-epicutaneous test, lymphocyte transformation test (TTL) and leukocyte migration inhibition test (LIF). Among the 130 (82.2%) patients suffering from contact dermatitis, with the positive patch tests to commercial or standard battery epicutaneous allergens, 26 (20%) had at least one positive patch test to the medicament. In these cases contact allergic medicamentous dermatitis (SAMD) was proved by positive clinical and allergic investigations. In only one case, patch test was negative, with booth the TTL and LIF test positive. Among the medicaments TTL and LIF tested, antibiotics were the most frequent in 9 (34.61%) cases, analgetics were found in 6 (23.08%). Professional contact allergy to medicaments has been estimated in 5 patients (19.23%). According to the obtained results and statistic findings, relationships between the two variables-TTL and patch test, and LIF and patch test, were estimated due to the contact allergy to medicaments. Both of them were low and negative without statistic significance. Patch test remains to be the irreplaceable test with regard to CAMD.
Adolescent↗
Allergic hypersensitivity to neomycin. Relationship between patch test reactions and 'use' tests.
The prevalence of neomycin patch test sensitivity in the general population is approximately 1%. We describe the relationship between positive neomycin patch tests and clinical "use tests" with two antibiotic combinations (Neosporin G cream and Neosporin ointment). The neomycin use test was positive in seven of eight subjects with a strongly positive patch test, and in two of four subjects with a weakly positive patch test. A positive use test usually occurred earlier and was always more intense with the cream base. The use test reactions were usually mild even with continued application of the antigen. Use tests with commercial products may be helpful in evaluating the clinical relevance of positive patch tests.
Drug Hypersensitivity↗
Seasonal influence on patch test results in Greece.
Several studies have been reported on the suppressive effect of ultraviolet B (UVB), UVA sunlight and PUVA on contact dermatitis. However, studies that have tested the hypothesis that patch tests reactions have a seasonal variation due to the suppressive influence of sunlight, had found conflicting results. In order to clarify the influence of climate conditions in Athens, Greece (sunlight, temperature, latitude 38 degrees) on patch tests results, data from 5468 patch-tested patients (1978-1990) were analyzed for monthly, seasonal variation. In addition, 180 patients with a high degree of sun exposure due to occupation that were prospectively re-patch-tested in a different season (i.e. summer versus winter), with the same allergens and technique, were studied and analyzed statistically. Climate data was provided by the Hellenic National Meteorological Service. The results indicate that there is no significant influence on patch tests reactions in Athens, Greece. This may in part be due to the small differences in climate conditions that exist between summer and winter in Greece.
Allergens↗
Results of routine office patch testing.
The results of patch testing over the past 18 months in a general dermatology clinic are presented and compared with the data recently reported by the North American Contact Dermatitis Group. Good correlation exists between the results of the two studies for all the reported allergens except nickel sulfate and potassium dichromate. The increased incidence of sensitivity to these allergens reported in our series probably reflects the tendency for all metal related contact dermatitis to be referred to our clinic, even though recognized as such by the referring physician. The 16.8% reactivity to a dye mix used in our screening kit, and not reported by others, proved most interesting. In the light of continuing reports of dye related allergic contact dermatitis, our experience prompts us to suggest that a dye mix of some sort should be evaluated in future large-scale studies of patch test screening kits.
Allergens↗
Pustular patch test reactions in atopic dermatitis.
Pustular patch test reactions to 5% nickel sulfate were regularly produced in patients with atopic dermatitis when patches were placed over areas of skin with (a) follicular papules, (b) erythema, (c) lichenification, and (d) minimal trauma. The pustular patch test reactions seldom occurred in the normal-appearing skin of these patients. However, if the skin was traumatized prior to the patch test, the reaction was produced in the normal-appearing skin of atopic as well as control individuals. No pustular reactions occurred in the follicular lesions of keratosis pilaris, supporting the view that follicular lesions of atopic dermatitis differ from keratosis pilaris. It is suggested that pustular patch test reactions are caused by primary irritation.
Adult↗
"Reactions" to standard patch test materials.
Twelve compounds tested by closed patch test at recommended concentrations produced numerous "Fallse positive" non-allergenic reactions in a panel of 100 vollunteers. These results indicate the need for further basic studies to determine appropriate non-irritating concentrations of materials used in biagnostic patch testing for contact allergy.
Adult↗
Standardization of patch tests in Japan.
In order to standardize patch tests in Japan a comparative study of our former method of patch testing with that recommended by the International Contact Dermatitis Research Group (ICDRG) was carried out with the collaboration of dermatologists in the Mid-Japan Dermatological Society. The following differences were observed between the two methods of patch testing: 1. Four out of five ICDRG allergens which were common in Japanese standard allergen series--formaldehyde, potassium dichromate, cobalt chloride and nickel sulfate--showed higher reactivity than those of Japanese allergens. The other allergen, paraphenylenediamine (PPD), showed the same reactivity as Japanese PPD. Cobalt chloride of ICDRG origin showed a particularly higher reactivity than the Japanese one (a=0.05) 2. Higher reactivity was observed at the 48-h reading when aqueous reagents were patch-tested using Torii-Ban, Miniplaster and Leukotest, which are all popular in Japan. This higher reactivity could be attributed to the lint gauze of plasters which are pre-treated with fluorescent whitener. 3. The incidence of reactivity of the ICDRG allergens in Japan was also studied in order to establish a new standard allergen series.
Cobalt↗
Multiple concomitant positive patch test reactions.
Thirty-five patients who showed 90 one plus (+) patch test reactions to 28 patch test chemicals at Day 2 (D2) were retested to the chemicals at D7. On retesting, 60% (54/90) reactions were positive but 42% (38/90) were negative at D9, suggesting that false positive patch test reactions were common when more than one positive reaction was obtained by concomitant patch testing. On retesting, the total % positivity was reduced from 344 to 241 suggesting that the true index of sensitivity was falsely exaggerated by concomitant testing.
Aged↗
Erythema multiforme reaction to patch testing.
A young woman developed erythema multiforme in association with multiple patch test reactions. Sequential patch testing revealed 2 true positive reactions (colophony and fragrance mix), and was not associated with flare of erythema-multiforme-type lesions. The development of erythema multiforme should be included in the list of possible adverse reactions to patch testing, albeit a rare occurrence.
Adult↗
Skin reactivity to metallic cobalt in patients with a positive patch test to cobalt chloride.
458 consecutive patients were patch tested with a metallic cobalt disc as a supplement to the standard series. 23 patients had a positive reaction to CoCl2 1% pet. Of these, 19 were tested with the cobalt disc. 11 had a positive reaction and 5 a questionable reaction. There were no positive reactions to the cobalt disc in patients with a negative patch test to CoCl2 1% pet. Patch testing with CoCl2 1% pet. diagnoses all patients with allergy to metallic cobalt, but the test method is limited by a high number of irritant and questionable reactions.
Cobalt↗